Drug scanning technology in use at Saranac Lake hospital

January 12, 2012

SARANAC LAKE - Nurses at Adirondack Medical Center are now using barcode scanning technology to administer medications to their patients.

Over the last few months, Adirondack Health has implemented a Bedside Medication Verification system at the Saranac Lake hospital. It's designed to prevent giving patients wrong or incorrect doses of medication. The system went live in all inpatient areas of the hospital in September.

"The leadership in the hospital has made a commitment to patient safety by training staff, installing a (BMV) system and providing equipment to support that," said Renee Gibbs, AMC's senior clinical systems analyst.

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Adirondack Medical Center nurse Kelly Burnett scans the wristband of patient Rita Early of Lake Placid before giving her medication Wednesday. The scanning is part of a new Bedside Medication Verification System that’s been implemented at the Saranac Lake hospital.(Enterprise photo — Chris Knight)

Tom Smith, pharmacy director at Adirondack Medical Center, works in the Saranac Lake hospital’s pharmacy area on Wednesday. Pharmacy staff are now putting barcodes on individual doses of medication as part of the hospital’s new Bedside Medication Verification system.(Enterprise photo — Chris Knight)

The BMV system basically has two components. Every patient who registers at the hospital now gets a "unique identifier number" in the form of a barcode printed on a wristband. Every dose of medication dispensed from the hospital's pharmacy also has its own barcode.

When the nurse arrives at the bedside to provide medication to the patient, they first use a barcode scanner attached to computer on a portable cart to scan the patient's wristband. Then they scan the dose of medication to ensure it matches with the doctor's orders for the patient, which have been put into the computer using another new technology called eMAR, or Electronic Medication Administration Record. If the medication doesn't match the patient's eMAR or is the wrong dose, a warning message will flash on the screen. If not, the nurse will then administer the medication to the patient.

"We're checking every med with the patient's identification, so we aren't going to give any medications that aren't scheduled or ordered," said AMC registered nurse Kelly Burnett. "Less med errors, that's the primary use of it."

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Hospital Pharmacy Director Tom Smith said the new technology reduces the amount of "human error" that can sometimes occur when giving a patient medication. He also said it means nurses spend more time at the bedside with their patients.

"Before, the nurses really had to go back to a central medication room to get their meds," he said. "This whole system has helped moved the nurses closer to the bedside so they're not hiking down the hall anytime they need something."

Asked if the new system can help deter or prevent the abuse of prescription narcotic drugs, a growing problem across the North Country, Gibbs said it could help.

"You have to be adjacent to a patient to have the wristband to scan," she said. "You have to have the medication adjacent to scan. And it has to be on the patient's ordered medication profile. When you look at that three-way process, I suspect that could be helpful there as well."

Hospital officials have been working to implement the BMV system for nearly a year. In August, more than 100 nurses on the hospital's inpatient floors were trained on the new technology, which went live in those areas the following month. Gibbs said they have continued to "roll out" BMV to other areas of the hospital. Emergency department staff are being trained on the new system now, she said.

For now, there are no plans to expand BMV to the AMC Lake Placid hospital or Adirondack Health's nursing homes in Lake Placid or Tupper Lake, primarily because those facilities don't use the same computer vendor as the Saranac Lake hospital.

Gibbs said the feedback from nursing staff who are using the new system "runs the gamut."

"It speaks to those who embrace change and those that take a little longer to see the benefit of change," she said. "But it only takes one experience for a nurse to go to the bedside, scan the patient's wristband and scan the med that they were quite convinced was the right med and at the right time, and for them to get a warning message. They look up at the monitor and go, 'I could have done something wrong. This is a tool that helps me protect my patient.'"

Hospital officials weren't able to say, offhand, how much the new system has cost.

"The real investment from the organization is the time for all of us to take the training, to make this plan, and there was a fair amount of equipment investment in terms of mobile carts, new scanning equipment and new packaging equipment in the pharmacy," Gibbs said. "Bulk drugs that come into the pharmacy have to be repackaged so every piece of medication has that unique barcode on it."

While improving patient safety was named as the main reason for implementing the new system, it's also being done because of a shift to "pay for performance" among the companies and agencies the hospital gets reimbursements from: Blue Cross-Blue Shield, Medicare and Medicaid.

"Right now, as this is being tested, you get a supplement if you meet the goals that you and the reimbursing agency have established," Gibbs said. "Sometime down the road, if you don't meet that goal you've established, you will lose a piece of that reimbursement. So it certainly is on every one of us to establish realistic goals, work with those agencies and to also be sure that our performance meets that criteria.